CMS Care Coordination

Benefits of Care Coordination

Families enrolled in the Children’s Medical Services (CMS) program find support and assistance within their communities while caring for their children with chronic health concerns. All families in the program have the right to receive quality services and assistance from their care coordinator.

Children's Medical Services Care Coordinators:

  • Encourage family participation in the healthcare decision-making process 
  • May provide home visits for clients and their families
  • Promote independence and choice for families
  • Aid with referrals to community resources
  • Support a medical home approach
  • Coordinate access to pediatric specialty care
  • Provide education and guidance in organizing health care and managing health conditions
  • Navigate options to help pay for healthcare
  • Assist with outreach and identifying respite care resources
  • Work cooperatively with a child's healthcare provider to create the most desired outcomes

Care Coordinators Guide Health Care Transition Planning

The journey from childhood to adolescence and into adulthood poses many challenges for youth with disabilities, especially in healthcare. Challenges such as finding an adult provider or securing adequate medical coverage can lead youth to underutilize medical services and/or misuse and abuse the emergency room during adulthood.  Care Coordinators help prepare youth and families to navigate services through schools, agencies, employment/training, and healthcare providers to create an effective path to greater adult independence. It is recommended that youth and families start planning for health care transition as early as 12 years of age.

What does Health Care Transition involve?

  • Moving from pediatric care to an adult model of care
  • Preparing youth to become responsible for their health care
  • Maximizing independence and providing support systems as needed
  • Helping youth feel comfortable speaking with their doctors
  • Teaching youth about their health condition
  • Learning to navigate services for youth over the age 18

Where can I find more information on Health Care Transition?

Take a closer look at the educational materials available to assist parents/caregivers and youth in the transition process:



Families Rights

Coordinating care for children in the CMS program requires a true partnership between the family and the child’s care coordinator. The  Download this pdf file. Family Rights and Responsibilities  help make sure that all the child’s needs are being met.

When families or patients are not satisfied with program decisions made regarding eligibility and services there is an appeals process. See Download this pdf file. Notice of Process to File an Appeal for more information.


Page last updated 12/12/2022